NPIMap

Organization Active NPI

Ican & Associates, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1063547701
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
047055 Issued in NC
Legal business name
ICAN & ASSOCIATES, INC.
Practice address
6112 Louise St
Fayetteville, NC 28314-2719
Phone
(910) 860-9787
Fax
(910) 860-3903
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shannon M Battle, M.A.
Title
Director
Phone
(910) 860-9787

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 10312009 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 047055 NC Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 026597 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL047055 NC

Addresses

Primary practice location

6112 Louise St
Fayetteville, NC 28314-2719

Mailing address

PO Box 25433
Fayetteville, NC 28314-5007
Phone (910) 860-9787

Other identifiers 1

IdentifierTypeStateIssuer
261QM0801XOtherNCLME

National Provider Directory

National Provider Directory
Tax ID family
Ican Associates Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1063547701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25433",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145007",
            "telephone_number": "910-860-9787",
            "fax_number": "910-860-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 LOUISE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142719",
            "telephone_number": "910-860-9787",
            "fax_number": "910-860-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAN & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "BATTLE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-860-9787",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NC",
            "license": "10312009",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "047055",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "026597",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL047055",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LME",
            "identifier": "261QM0801X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.